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February 18, 2022

Muhammad Ateeq, of Rawalpindi, Pakistan, was sentenced to 12 years in prison and ordered to pay more than $50 million in restitution for forfeiture for submitting fraudulent claims to Medicare for home health services. Ateeq acquired and managed home health agencies in the United States, using false identities. He then used these home health agencies to submit fraudulent Medicare claims totaling over $40 million for services not rendered. The ill-gotten gains were laundered through U.S. bank accounts designated by overseas customers of overseas money transmitting businesses. Cash payments were then transmitted to accounts in Pakistan which Ateeq controlled. Fraud proceeds were also used to purchase luxury items which were delivered to Ateeq’s Dubai associates. DOJ

Tagged in: Criminal Proceedings, Healthcare Fraud, Home Health and Hospice, Medical Billing Fraud,

December 1, 2021

A collection of hospices known as Crossroads Hospice has agreed to pay $5.5 million to settle allegations raised in two qui tam suits by former employees Leanne Malone, Jackie Burns, and Angela Heck, and a home health physician in Tennessee, Dr. David Weber.  In their lawsuits, the whistleblowers alleged that between 2012 and 2014, Crossroads billed Medicare for hospice care for patients who were not terminally ill, including patients with Alzheimer’s or dementia.  Malone, Burns, and Heck will divide a million-dollar relator’s share.  USAO WDTN

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Whistleblower Case, Whistleblower Rewards,

November 23, 2021

A number of related entities operating in Ohio and Tennessee as Crossroads Hospice have agreed to pay $5.5 million to resolve allegations that they submitted false claims for hospice services that were not covered by Medicare.  Specifically, the government alleged that over a period of three years, Crossroads submitted claims for dementia or Alzheimer’s patients who were not terminally ill for at least a portion of the more than three years that the patients received care.  Two qui tam actions were filed regarding the false claims; the three individuals who jointly filed the first action, Leanne Malone, Jackie Burns and Angela Heck, were previously employees of Crossroads, and will receive approximately $1.045 million.  DOJ

Tagged in: Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

November 22, 2021

Home health provider PruittHealth, Inc. has agreed to pay $4.2 million to resolve allegations that they knowingly submitted false claims for services that were not eligible for reimbursement because, among other things, they did not have the required face-to-face certifications or plans of care, and they did not document the beneficiary’s homebound status or need for the home health services.  Tina Peery, who initiated the government action by filing a qui tam complaint, will receive an award of $700,000.  USAO ND Ga

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

November 1, 2021

Geisinger Community Health Services, based in Pennsylvania, has agreed to pay over $18.5 million to resolve its liability following a self-disclosure of violations of the False Claims Act.  The violations occurred between 2012 and 2017 and involved physician certifications of terminal illness, patient elections of hospice care, and physician face-to-face encounters with home health patients.  USAO MDPA

Tagged in: Certifications, FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Provider Fraud,

September 8, 2021

Bayada Home Health Care, Inc. and related entities agreed to pay $17 million to resolve allegations of paying unlawful kickbacks that were initiated by a whistleblower action under the False Claims Act.  The government alleged that Bayada purchased two home health care agencies from a company that owned retirement communities in order to induce referrals from the seller to Bayada.  The whistleblower, David Freedman, was the director of strategic growth for Bayada; he will receive more than $3 million as a whistleblower reward.  DOJ; USAO NJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Home Health and Hospice, Whistleblower Case, Whistleblower Rewards,

September 7, 2021

The founder of Agape Healthcare Systems, Inc., Timothy Mark Harron, was sentenced to 12 years in prison and ordered to pay $4.3 million in restitution following his guilty plea on healthcare fraud charges.  Harron and his wife, Latisha Harron, scoured obituaries for recently deceased Medicaid recipients and billed Medicaid for up to a year of home health services that were allegedly provided to the deceased by Agape.  Latisha Harron was previously sentenced to 14 years in prison.  NC

Tagged in: Criminal Proceedings, Healthcare Fraud, Home Health and Hospice,

May 19, 2021

Latisha Harron of North Carolina has been sentenced to over 14 years in prison and ordered to pay over $13 million in restitution after pleading guilty to charges of defrauding the North Carolina Medicaid Program, aggravated identity theft, and money laundering.  Together with husband Timothy Harron, the defendant scoured obituaries for recently deceased Medicaid recipients and billed Medicaid for up to a year of home health services that were allegedly provided to the deceased by her company, Agape Healthcare Services, Inc.  By concealing the fact that both Harrons were previously convicted felons, the defendant was able to obtain millions in reimbursements, which she then laundered into expenses such as business properties, a private jet, clothing and jewelry, and gym equipment.  NC AG; Subsequent proceeding

Tagged in: Criminal Proceedings, FCA State, Healthcare Fraud, Home Health and Hospice, Medicaid,

May 4, 2021

Alberto Orian Gonzalez-Delgado was sentenced to 210 months in prison after pleading guilty to conspiracy to commit health care fraud and wire fraud.  He is the last of eight individuals to be sentenced for a money laundering scheme in Florida and Michigan involving the use of nominee owners to fraudulently purchase home health agencies and then bill Medicare for services that were never provided to Medicare beneficiaries.  The defendants caused the payment of approximately $53 million in fraudulent claims.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Money Laundering,

May 4, 2021

After being convicted of running a $11 million healthcare fraud scheme, Brenda Rodriguez, the owner and operator of Texas-based QC Medical Clinic, has been ordered to spend 25 years in prison, followed by 3 years of supervised release.  As shown by evidence presented at trial, Rodriguez’s scheme involved paying doctors to approve Medicare beneficiaries for home health services, selling the approvals to various home health providers, and causing the providers to bill Medicare for services that were medically unnecessary, never provided, and/or arose from illegal inducements.  USAO SDTX

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity, Medicare,

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